Promoting the Appropriate Use of Oral Antibiotics: There Is Some Very Good News

Over just the past 5 years Pediatrics has published 32 papers1–32 and an entire supplement33 related to the appropriate use of antibiotics and antibiotic resistance. Obviously, because of the increasing incidence of bacterial resistance, particularly of multidrug-resistant Streptococcus pneumoniae , this issue is critically important, impacting on the health and well-being of children. At a conference at the Agency for Healthcare Research and Quality (AHRQ) on April 10, 2002, clinicians, investigators, and representatives from the AHRQ, Centers for Disease Control and Prevention, National Institutes of Health, Food and Drug Administration, and Department of Defense explored the progress made in this area and delineated unanswered questions. There is some very good news. First, oral antibiotic prescriptions for children are declining in the United States. The rate of decline appears to be variable, but it is estimated at between 20% and 40% since the early 1990s. This information is derived from two large national databases and hence reflects prescribing in general, and is not specific for pediatricians.34,35 The data about reduced prescribing are corroborated by a national survey of pediatricians … Reprint requests to (H.B.) Boston Medical Center, Maternity Building, 91 East Concord St, Boston, MA 02118. E-mail: howard.bauchner{at}bmc.org